The DOTS+MOBILE (Drug Overdose and Occupational Safety Training + Mobile Buprenorphine Rescue Intervention for Life Saving Encounters) project empowers first responders to reduce opioid overdose deaths in Missouri. Our program improves post-overdose outcomes for people who use drugs by distributing naloxone to first responder agencies, training in OD response best practices, and enabling on-scene referrals to addiction treatment.

DOTS+MOBILE is also facilitating six Fire/EMS agencies in Missouri to implement the cutting-edge practice of medic-initiated Buprenorphine in the field. This practice when used by other agencies shows extremely promising early results for post-overdose survivability.

Target Counties:

St. Louis City, St. Louis County, St. Charles, Jefferson, St. Francois, Washington, Franklin, Boone, Phelps, Greene, Jackson, Buchanan

Objectives of Grant:

  • Training for First Responders

  • EMS Initiated Field Buprenorphine

  • Collaborations between First Responders and Community Treatment

  • Naloxone Distribution

Training for First Responders

The DOTS+MOBILE team is partnering with the Safety & Health Integration in the Enforcement of Law and Drugs (S.H.I.E.L.D.) initiative of Northeastern University to bring their first responder Occupation Safety training to Missouri.

Training is worth 3 hours of POST credit for law enforcement and CEUs for EMS in Missouri

EMS Initiated Field Buprenorphine

Beginning in March 2024, six EMS agencies across Missouri will begin field administrations of the medication buprenorphine, an FDA-approved medication to treat Opioid Use Disorder, to patients who have just overdosed on opioids. The pilot districts will receive guidance from Dr. Gerard Carroll an EMS and Addiction physician who pioneered this initiative. Buprenorphine works by blocking and partially activating the opioid receptors, both relieving patients of their withdrawal symptoms and cravings and also reducing the chances of future overdose. Paramedics will also work to connect patients to higher levels of care for Substance Use Disorder. Using the Engaging Patients in Care Coordination (EPICC) Project, the paramedics ensure patients receive assistance from Recovery Coaches - individuals with lived experience with Substance Use Disorder. These Recovery Coaches will partner with the patients to help them obtain medication, housing, and treatment resources, thereby ensuring the long-term health and safety of individuals in crisis

Collaborations between First Responders and Community Treatment

We improve first responders’ ability to make appropriate post-overdose service connections by increasing the number and quality of cross-sectoral collaborations between first responders and community treatment, recovery, and other social service providers. We capitalize on existing Community Behavioral Health Liaison (CBHL) and EPICC (Engaging Patients In Care Coordination) programs in the target counties. We aim to foster relationships between first responder entities and the CBHLs and EPICC programs and assist with formalizing the referral process. This enhanced collaboration boosts first responders’ ability refer individuals who overdose.

Naloxone Distribution

The DOTS+MOBILE team distributes naloxone to trained first responder agencies within hotspot areas across Missouri. EMS is trained to leave behind naloxone with individuals who survive an overdose and their family members or associates. Leave-behind naloxone programs are imperative to further diffuse naloxone access among networks of people who may be actively using drugs or have relationships with individuals who are actively using and are at increased risk for opioid overdose.

Community Of Practice/Train the Trainers

  • Between September 2023 through April 2024 CoPs were lead by the nations leading expert in EMS Buprenorphine in order to train and prep EMS departments to implement their own programs

  • 21 paramedics were trained to to disseminate EMS initiated Buprenorphine to their departments

  • About 500 EMS personnel will be trained

EMS districts will begin administering Buprenorphine starting Spring 2024

Funding Sources

MO Department of Mental Health is using Opioid Settlement Dollars to fund the DOTS+MOBILE project

EMS PARTNERS

Central Jackson County Fire Protection

Raytown Fire Department

Mehlville Fire Protection District

MU Health Care EMS

Joachim - Plattin EMS

Christian Hospital EMS

EPICC PARTNERS

Missouri Hospital Association (MHA)- Western and Central Missouri

Behavioral Health Network of Great St. Louis- Eastern region